Shank received mixed reviews from critics, but generally positive reception overall. The PlayStation 3 version holds a score of 75.86% at GameRankings, while the PC version holds a score of 76.33% and the Xbox 360 version a 75.11%. In its first week over 9,200 units were sold on Xbox Live Arcade, and in August 2010 alone sold 41,000 units on the same system. It remained in the top 20 Xbox Live Arcade games for the month of September 2010. Critics generally praised the art style of both the gameplay and cutscenes, however some critics felt the game had uneven level design and repetitive gameplay.

Shank is a side scrollingbeat 'em up with a comic book art style. In the game the player controls Shank, an ex-mobhitman. The game features three main types of weaponry: a pair of knives, heavy melee weapons (the starting one is a chainsaw) and firearms (the starting one is a pair of pistols). Each weapon is assigned to a controller button, and the attacks can be combined to perform various combos. The player can collect temporary-use weaponry from fallen enemies, such as machine guns and rifles, as well as grenades.

Shank has other attacks such as multiple grapple attacks, throw enemies, and is able to perform a pounce maneuver, in which he jumps in the air and lands on a nearby enemy. Some acrobatic abilities can also be performed, such as swinging from lampposts or other tall structures, and running along the front of things such as billboards. On screen enemies each have a health bar that displays on the player's heads up display, akin to Final Fight.